Provider Demographics
NPI:1467241356
Name:BUCKHEAD DENTAL CENTER
Entity type:Organization
Organization Name:BUCKHEAD DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ERLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-971-3889
Mailing Address - Street 1:2282 PEACHTREE RD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1147
Mailing Address - Country:US
Mailing Address - Phone:404-603-8350
Mailing Address - Fax:404-603-8115
Practice Address - Street 1:2282 PEACHTREE RD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1147
Practice Address - Country:US
Practice Address - Phone:404-603-8350
Practice Address - Fax:404-603-8115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1255385696OtherDR. ROMAN CINIRKA
OH1538547872OtherDR. LUSHA XU